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High School Volunteer Application

High School Volunteer Application
Volunteers must complete this form one time each school year.
All UCA Volunteers are subject to a Criminal History background check that covers the following:
-Comprehensive Criminal Check
-Statewide Criminal Check
-Sex Offender Registry
-Other Criminal Record: SW Security Watch List
Please fill out the Background Check Consent Form and deliver it to the school.

Waiver of Liability 

The School District does not provide insurance coverage to non-District personnel serving as volunteers for the School  District. The purpose of this waiver is to provide notice to prospective volunteers that they do not have insurance coverage  by the School District and to document the volunteer’s acknowledgement that they are providing volunteer service at their  own risk. 

By your submission below: 

You acknowledge that the School District does not provide insurance coverage for the volunteer for any loss, injuries,  illness, or death resulting from the volunteer’s unpaid service to the School District. You agree to assume all risk for death  or any loss, injury, illness or damage of any nature or kind arising out of the volunteer's supervised or unsupervised service to the School District. You also agree to waive any and all claims against the School District, or its officers, School  Board members, employees, agents or assigns, for loss due to death, injury, illness, or damage of any kind arising out of  the volunteer’s supervised or unsupervised service to the School District.


Name (Last, First)
Phone Number
Street Address
City
Zip Code
Personal Physician
Physician's Telephone Number
Emergency Adult Contact Name
Emergency Adult Contact Phone Number
Are you now or have you ever been a school volunteer?
If yes, at which school?
Name(s) of any child(ren) attending this UCA High School
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To validate your submission, please type the answer to the question.

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